Assessment of effectiveness of community based physiotherapy and development of a guideline for community based therapy

Kabul | Kabul

  • Background

1.1 Swedish Committee for Afghanistan (SCA)

Swedish Committee for Afghanistan (SCA) is a non-governmental, non-profit, membership based and value driven organization established in 1980 with the mission of empowering individuals, communities and local organizations, primarily in rural areas and with particular focus on women, girls, boys and vulnerable groups such as people with disabilities so that they may participate fully in society and influence their own development. SCA is presently implementing development programmes on Health, Education, Disability and Rural Development in 14 provinces with a total annual budget of roughly USD 40 million. The main contributors to SCA budget are Sida, World Bank and increasingly, private contributions and donations. SCA has more than 5,000 staff and manages its operations through the Kabul Management Office (KMO), Stockholm Management Office, five Regional Management Offices and two Liaison Offices.

SCA strategic plan 2014-2017 focuses on rural communities, women, children and persons with disabilities. It built upon SCA’s previous successes and competencies. Service delivery, capacity development, advocacy, gender mainstreaming and rights based approach are the key building blocks of the new organizational strategy. Strategic plan 2014-2017 emphasizes working in close collaboration with the communities that SCA supports. Its programmatic activities are guided by respect for the context and the principle of local ownership. Emanating from a rights-based perspective, SCA supports the capacity development of rights holders in the form of civil society organizations. It continues to commit itself to strengthening the voice of women and enhancing the capacities of civil society organizations to engage women more meaningfully.

1.2. Programme Description:

Disability is a cross cutting issue within SCA programming and the organization has strategically included persons with disabilities as right holders in all its five strategic objectives. The organization implements both community and institutional based rehabilitation programmes along with inclusion of disability in health, rural development and education programmes. The Disability Programme of SCA operates from a Community-Based Rehabilitation (CBR) perspective of the World Health Organization for rehabilitation, equalisation of opportunities, poverty reduction and social inclusion of people with disabilities’ (ILO, UNESCO & WHO, 2004).[1] The comprehensive CBR programmes of the organisation include five sub-components namely social integration, employment support, special and inclusive education, physical rehabilitation services and capacity & institutional development. The programme is planned and coordinated by the disability programme unit based in Kabul and implemented from four regional offices in Mazar-e-Sharif, Ghazni, Taloqan and Jalalabad in 13 provinces covering 45 districts. Physical rehabilitation is an inherent component of rehabilitation, is gaining more attention within the national healthcare structure of Afghanistan. Swedish Committee for Afghanistan has been providing physiotherapy services through its physiotherapy centres established in 12 provinces as well as through home based therapy intervention under the CBR programme. However, since physiotherapy is included under Basic Packages of Health Services, SCA has handed over 23 physiotherapy clinics located in the provincial and district hospitals to the Government Health Department by integrating these into health system and shift the focus to strengthen community-based interventions such as provision physiotherapy, occupational therapy and prosthetic, orthotic and other mobility and assistive devices through home-based interventions, outreach programs and mobile workshops.

2.Purpose and scope of the consultancy

With this backdrop, there is a need to study to understand the impact of handing over physiotherapy clinics on the CBR programme of SCA, assess the effectiveness of current community based therapeutic interventions, identify the needs, gaps and recommend the Disability Programme for appropriate intervention methods and techniques to improve the quality and coverage of therapeutic services through a community based approach. Further, there is need to build the capacity of physiotherapists and CBR staffs on the role of physiotherapy/occupational therapy in CBR, appropriate community based therapy techniques (physiotherapy and occupational therapy), Activities of Daily Living (ADL) training, management of different conditions like club feet, cerebral palsy with multiple impairments, spinal cord injuries and other severe types of physical impairment.

The purpose of the study is

“To redesign the community based therapy approaches based on recommendations of the evaluation to make the therapeutic programme more effective and relevant for men, women and children with disabilities at community level”

2.1. Objective and specific objectives of the consultancy:

The overall objective of the consultancy is “to assess the relevance and effectiveness of current community based therapy approaches, explore scopes for further expansion and develop a guideline on community based therapy”

Specific objectives

  • To assess whether community based therapy approach is based on the needs of the target group and aligned with the policy framework of the Government of Afghanistan
  • To assess the quality of current home based therapy and its relevance in Community Based Rehabilitation programme
  • To evaluate the impact of the handed over physiotherapy clinics on the quality of home based therapy activities of the disability programme and provide SCA with appropriate recommendations on how to mitigate any possible negative impact of handing over on quality of physiotherapy services.
  • To explore the opportunity for expansion of community based therapy as an alternative approach
  • To assess the strengths and weaknesses, including the structure of human resources and their capacity in delivering community based physiotherapy
  • To recommend appropriate approaches, physical and human resources needed for effective implementation of community based therapy programme
  • To assess the knowledge, attitude and practices of CBR team and physiotherapists and identify the capacity building needs
  • To develop a short guideline on community based therapy in context of Afghanistan**3. Evaluation Methodology:**

Suggested methodology for consultancy includes a desk review of documents and systems, discussion with key staffs of the disability programme, semi structured interviews, focus group discussion, field visit and observation and interview of key stakeholders

  • The relevant documents like SCA project proposal, strategy documents, work plan, evaluation reports and existing tools and materials will be provided in advance for understanding programme and context
  • The consultant will present a detailed description of sampling strategy, data collection instruments and procedures, sources of information and procedure of data analysis. On arrival the consultant will meet the disability team to finalize the methodology and develop a draft training module
  • The consultant will meet the key people of the disability programme in the KMO, the Disability and Rehabilitation Department of Ministry of Public Health, visit the field offices Jalalabad, Mazar, Taloqan and Ghazni and interact with CBR team, physiotherapists, target people with disabilities households and other stakeholders to understand the needs and effectiveness current approach to physiotherapy (both community and institution based). The feedback of service users and government officials should be given utmost importance along with feedback of CBR workers and physiotherapists
  • The assessment will cover both institutional and community based physiotherapy approaches, rural and urban areas with gender and age group balance
  • The consultant will suggest the strength and weakness in the current approach to physiotherapy and recommend for appropriate adaptation needed in the community based therapy approach
  • Based on the field experience the consultant will develop a guideline on community based therapy and finalize it in consultation with the disability programme coordination and technical team
  • Overall participatory approach to planning and assessment will be used throughout where concerned right holders, duty bearers and other stakeholders will have active involvement from the design of the assessment to the final report and training of the staffs.
  • However, it is expected that the consultant will send a proposal along with clear methodology and an activity plan which will be finalized in consultation with key management and technical staffs of the disability programme and M&E programme units.

4. Scheduling (timetable/work plan)

The consultancy will be for about 30 official working days, including two days of travel within Afghanistan. It does not include weekends, and travel days from home country and back. However, the consultant will submit a timetable and work plan with clear deliverables at each stage of the process along with the proposal, which will be reviewed and finalized in consultation with the Disability Programme Manager, the Senior Disability Programme Specialist, the M&E Advisor/M&E Manager and the Senior Officer "Physical Rehabilitation. The evaluation is likely to start from 15th July 2016.

5. Reporting and Deliverables

  • Inception report, including plan for assessment will be received from the consultant from his home country before arrival in Kabul. The inception report should cover the consultant’s understanding of the terms of reference, the methodology to be used for evaluation and a work plan/schedule for field visits and major deadlines (the format to be provided by the SCA)
  • Draft assessment report to be submitted by the consultant, including the information on relevance of community based therapy, strength, weakness, opportunity and challenges in the current approach with realistic, practical recommendation appropriate to the Afghanistan context for further improvement in approach at the end of field evaluation (the template to be provided by the SCA).
  • Final Report: The consultant will present the findings before a panel and receive the feedback within a week. The final report should be submitted by the end of the first phase of consultancy.
  • Guideline for community based therapy: The consultant will develop a short guideline suggesting changes in the current community based therapy programme and recommend strategy for making community based therapy programme more appropriate and effective

6. Management of the task

A panel consisting of the Programme Director/Deputy Programme Director, the M&E Advisor/M&E Manager, the Disability Programme Manager, the Senior Disability Programme Specialist will DP and the Senior Officer "Physical Rehabilitation review the proposal, interview the candidates and assign the job. The disability programme will take care of the administrative issues of the consultation.

7. Swedish Committee for Afghanistan’s (SCA) Commitment towards consultant

SCA is contracting agency for the proposed evaluation of the Community Based Therapy programme. SCA through its disability programme and M&E team based in Kabul Management office and regional offices are actors and main stakeholders in the programme. Therefore, the disability programme and M&E team will support and take part in the assessment. The major roles and responsibilities of SCA include

  • To provide relevant project-related information and documents,
  • SCA to facilitate meetings with different stakeholders, target groups and duty bearers
  • SCA will provide to and fro flight tickets and other travel costs from the country of residence of the consultant as well as flights and land transportation within Afghanistan for field visit including accommodation and office space.
  • SCA will provide consultancy fee as per the agreement which may be deposited in the bank account of the consultant
  • If necessary, SCA will provide a translator during the field trip.
  • SCA will also cover the necessary visa and insurance costs.
  • SCA will provide necessary security updates and guidance during the stay of consultant in Afghanistan

8. Qualification, experience and competencies required for the assignment

8.1. Essential qualifications and experience:


  • Person with Bachelor or Master Degree in Physiotherapy or Occupational Therapy


  • Minimum 5 years of practical experience in physiotherapy and minimum three years’ of experience in Community Based Therapeutic intervention
  • Experience in designing guidelines for community based therapy
  • Proficient in the design and use of participatory methods of research.
  • Good understanding of gender issues and power structures at the community level.
  • Objectivity and ability to operate systematically with minimal supervision.
  • Result-oriented and committed to respecting deadlines.
  • Highly proficient in written and spoken English. Should be able to produce quality report at the end of the mission

8.2. Desirable qualifications and experience:

  • Knowledge and experience in Community Based Rehabilitation (CBR), and disability inclusion.
  • Background knowledge of the historical and political situation in Afghanistan.
  • Experience of working in a volatile situation
  • Flexibility to adapt to the evolving situation
  • Knowledge of spoken Dari or Pashto a plus

SCA deducts income tax from the consultant’s fee in accordance with Afghan tax law. At present this deduction is 2% for experts holding a consultancy license issued by the Government of Afghanistan, and 7% for experts not holding a consultancy license of the Government of Afghanistan.

[1], accessed on 18 March 2012.

Submission of proposals:

The following should be put forward in the application

  • A brief proposal of three pages, but not exceeding five pages explaining the proposed design, methodology for assessment and work plan
  • List of research and training conducted.
  • Curriculum Vitae, detailing her or his qualifications and experience relevant to the assignment.
  • Two works related reference, one of them, preferably related to the assignment
  • A specification of the total days and budget. Please note that insurance, accommodations, and travel within Afghanistan will be arranged and paid by SCA.
  • Financial Proposal, including:
  • Consultant’s daily fee (excluding weekends)
  • Travel + visa costs to Afghanistan
  • Any other costs associated with the evaluation
  • Afghanistan tax, which is 2% of those firms/consultancies which are registered in Afghanistan and 7% of non-registered consultants and firms.

Please put forward your application email to: The subject of the mail should be as follows: Your Name CPT evaluation 2016 - for example: Marshal CPT Evaluation 2016.

For further queries please contact Mohammad Amin Qanet Disability Programme Manager at: or Bikram Keshari Mohapatra, Senior Disability Programme Specialist at:

Before applying, please make sure that you have read the requirements for the position and that you qualify.
Applications from non-qualifying applicants will most likely be discarded by the recruiting manager.
  • Organization: SCA - Swedish Committee for Afghanistan
  • Location: Kabul | Kabul
  • Grade: Mid/Senior
  • Occupational Groups:
    • Social studies
    • Social studies
    • Civil Society
    • Civil Society
    • Monitoring and Evaluation
  • Closing Date: 2016-05-05

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